Comment: Health care: Be careful what you wish for

An opinion piece in this newspaper stated that “Canada is facing a health care squeeze.” That is true, but so is every other country in the world. Germany has a problem, the United States has a problem and so does China. It has nothing to do with how health care is funded.

It is simply a result of the fact that as the population ages, the number and severity of health issues increases and one can educate and license only a limited number of physicians, nurses and technicians.

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Since health care professionals have not yet perfected the art of being in two places at once, wait times are inevitable and it doesn’t matter who pays.

But never mind. Some have proposed the solution that is supposed to fix this is to change the current Canadian single-stream publicly funded health care system to a system like that of the United States, where both public and private funding run side-by-side.

Before doing that, there are facts that should be kept in mind, but that are generally ignored by those who advocate a U.S.-style approach.

First, many U.S. economic experts believe that elderly couples will need between $200,000 and $300,000 US in savings just to pay for the most basic medical coverage.

Second, U.S. studies have shown that 67 per cent of all bankruptcies in that country are a result of medical expenses, where 68 per cent of those had medical insurance. That means every 30 seconds in the United States, someone files for bankruptcy in the aftermath of a serious health problem even though they had insurance.

Third, even under the Patient Protection and Affordable Care Act which was introduced by president Barack Obama and which requires all residents to have health insurance or face a fine of 2.5 per cent of their taxable income, 32.5 million people have no access to health care at all.

That’s because they are too “rich” to qualify for Medicaid or not old enough to qualify for Medicare.

And finally, more than 96 per cent of physicians who leave Canada to practise in the U.S. return here.

That’s because, in Canada, they can prescribe all medically necessary services: In the United States, they can prescribe only what is covered by the patients’ insurance. That means they cannot follow the Hippocratic Oath to act in the best interest of their patients.

Oh, yes, “wait times are longer in Canada than in the U.S.”

To use U.S. President Donald Trump’s favourite phrase, “that’s fake news.” It leaves out the important fact that it applies only to the people who can afford to pay for private insurance and even then, they may go bankrupt. Compare that with Canada!

A final point: There is only one case where a country changed from a publicly funded system like Canada’s to a two-stream system like that of the United States. That was Australia.

It found that this increased wait times in the public system for two reasons: “Cream skimming” and shortage of physicians. The private strand would only take cases that allowed it to make a profit; and physicians who worked in the private system had to withdraw that time from the public system.

A health care squeeze? Sure, but before we change the system, we should make sure that the alternative is in keeping with the Canadian values of equality and justice — everyone has a right to health care — and that the alternative is not worse.

Eike-Henner W. Kluge has taught at various universities in the US and Canada before coming to the University of Victoria. He has received the award for Research Excellence of the UVic Faculty of Humanities and the Abbyann Lynch Medal in Bioethics by the Royal Society of Canada.

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